How medical students demonstrate their professionalism when reflecting on experience.

OBJECTIVES: This paper aims to examine the discourses used by students in a formal assessment of their ability to demonstrate professional values when reflecting on their experiences.
METHODS: We carried out a discourse analysis of 50 randomly selected essays from a summative assessment undertaken by all five year groups of students in one UK medical school.
RESULTS: Students were able to identify a wealth of relevant examples and to articulate key principles of professional practice. They were also able to critique behaviours and draw appropriate conclusions for their own intended professional development. Detailed textual analysis provided linguistic clues to the depth of apparent reflection: recurrent use of rhetorical language with minimal use of first-person reflections, lack of analysis of underlying factors, and simplistic views of solutions may all indicate students whose ability to learn by reflection on experience needs further development. There were also areas in which cohorts as a whole appeared to have a limited grasp of the important professional issues being addressed.
CONCLUSIONS: Assessing written reflections is a useful way of making students link their experiences with professional development. The detailed analysis of language usage may help to refine marking criteria, and to detect students and course components where reflective learning competencies are not being achieved.